American College of Chest Physicians, Oct. 30-Nov. 4, 2010

The 76th annual meeting of the American College of Chest Physicians (ACCP), CHEST 2010, took place Oct. 30 to Nov. 4 in Toronto, and attracted over 4,500 participants from around the world. The conference highlighted advances in pulmonary, critical care, and sleep medicine, with presentations focusing on patient care, practice management, implementation of clinical recommendations from the ACCP evidence-based guidelines, and novel and innovative approaches to the practice of chest medicine.

In a retrospective study, Kathleen A. Sala, of the Connecticut Children's Medical Center in Hartford, and colleagues found that severe asthma exacerbations in children are often triggered by allergies.

"We evaluated 188 children that were admitted to the hospital with asthma over a one-year period. Approximately 30 percent of these children experienced a near-fatal asthma attack that required ICU [intensive care unit] admission," Sala said. "As expected, we found that children admitted to the ICU required significantly longer durations of oxygen and continuous albuterol, and had significantly longer lengths of stay compared to children with less severe attacks."

The investigators found that children admitted to the ICU were four times more likely to report an allergic trigger for their exacerbation than children admitted to the ward. They also had significantly shorter durations of their illness before being admitted to the hospital, suggesting a rapidly progressing attack.

"Near-fatal asthma exacerbations were not significantly associated with a child's baseline severity of asthma. Even patients with mild asthma can develop these severe exacerbations requiring ICU admission," Sala added. "Therefore, in all children with asthma, every effort should be made to avoid allergens and irritants that may trigger an exacerbation, and clinicians should provide the most rapid care should an exacerbation occur."

In another study, Arn H. Eliasson, M.D., of the Integrative Cardiac Health Project in Washington, D.C., and colleagues found that stress reduction is associated with improved sleep quality and cardiovascular disease risk factors, including glucose metabolism and lipid levels. Using the Perceived Stress Scale (PSS) and the Pittsburgh Sleep Quality Index, the investigators measured changes in stress levels and concomitant changes in sleep quality.

"Subjects who were able to lower their perceived stress levels in response to the heart health program benefited with improved sleep quality. Of equal interest, the reduction in PSS also correlated with improvements in glucose metabolism (glucose levels and insulin levels) as well as improvements in Lp-PLA2, a serum lipid highly correlated with stroke risk. The improvements were statistically and clinically relevant," Eliasson said. "We believe that these findings substantiate the need to assess and target stress reduction because of its positive impact on sleep and its importance for cardiovascular health."

William Carroll, M.D., of the Derbyshire Children's Hospital in the United Kingdom, and colleagues conducted telephone interviews with 1,284 parents worldwide (228 in Canada) with at least one child with physician-diagnosed asthma, aged 4 to 15 years. In addition, interviews were conducted in 943 children with asthma worldwide, including 159 in Canada.

The investigators found that Canadian children were more likely to report asthma as a barrier to playing sports (54.1 versus 35.2 percent), feeling sad (18.2 versus 12.1 percent), and feeling left out (13.2 versus 8.4 percent), compared with children from other countries. In addition, Canadian children were less likely to feel "no different" from other children (31.5 versus 51.4 percent) due to their asthma. The investigators also found that complete asthma control was only 11.8 percent in Canada and 15.3 percent in other countries, which the investigators attributed to concerns about the use of steroid medication in the countries studied.

"Our data show that, in Canada, and in other countries, there is a lack of complete asthma control in children, and steroid phobia among parents is common," Carroll said in a statement. "However, the impact that lack of control has on children's lives seems to be greater in Canada."

WEDNESDAY, Nov. 3 (HealthDay News) -- Asthma appears to be strongly associated with lung cancer development, according to research presented at the annual meeting of the American College of Chest Physicians, held from Oct. 30 to Nov. 4 in Vancouver, Canada.

TUESDAY, Nov. 2 (HealthDay News) -- Coaches of student athletes with asthma may be inadequately prepared to identify the need for and deliver basic emergency asthma care, according to data presented at the annual meeting of the American College of Chest Physicians, held from Oct. 30 to Nov. 4 in Vancouver, Canada.

TUESDAY, Nov. 2 (HealthDay News) -- Antioxidant deficiency may contribute to decreased lung function in men with chronic obstructive pulmonary disease (COPD), according to data presented at the annual meeting of the American College of Chest Physicians, held from Oct. 30 to Nov. 4 in Vancouver, Canada.

TUESDAY, Nov. 2 (HealthDay News) -- Individuals with diabetes and a history of lung cancer who have been exposed to metformin and/or thiazolidinediones (TZDs) appear to be at a lower risk for metastatic lung cancer and may survive longer, according to data presented at the annual meeting of the American College of Chest Physicians, held from Oct. 30 to Nov. 4 in Vancouver, Canada.

MONDAY, Nov. 1 (HealthDay News) -- The use of communication technology among children and adolescents prior to bed appears to be associated with excessive movements, insomnia, and leg pain during the night, and may negatively impact mood and lead to cognitive problems during the daytime, according to data presented at the annual meeting of the American College of Chest Physicians, held from Oct. 30 to Nov. 4 in Vancouver, Canada.